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Antibiotics are not helpful in preventing fluid buildup in children with ear infections


When prescribed to children with middle ear infections, antibiotics are not associated with a significant reduction in fluid buildup in the ear, according to a meta-analysis of previously published studies.

Ear infections are among the most common diseases in infants and children. Middle ear infections ( acute otitis media ) may lead to fluid buildup in the middle ear, a condition known as otitis media with effusion. The effusion may lead to a conductive hearing loss of 15 decibels to 40 decibels, and this hearing loss could have an adverse effect on language development, cognitive development, behavior and quality of life.

Laura Koopman, of University Medical Center Utrecht, the Netherlands, and colleagues analyzed data from 1,328 children age 6 months to 12 years with acute middle ear infections who participated in five randomized controlled trials comparing antibiotics to placebo or to no treatment. A total of 660 children were assigned to not receive antibiotics.

Overall, 44 percent of the children were younger than age 2 and 51.8 percent had recurrent ear infections. The risk of developing middle ear effusion was highest for children in these groups. Children taking antibiotics were 90 percent as likely to develop effusion as those who did not take antibiotics, but this difference was not statistically significant.

Because of a marginal effect of antibiotic therapy on the development of asymptomatic middle ear effusion and the known negative effects of prescribing antibiotics, including the development of antibiotic resistance and adverse effects, the Authors do not recommend prescribing antibiotics to prevent middle ear effusion.
The results align with current treatment guidelines, which do not recommend prescribing antibiotics to prevent effusion.

Source: Archives of Otolaryngology - Head & Neck Surgery, 2008

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